Equal wound complications for staples, suture in obese women
Lindsay M. Kuroki, M.D., from the Washington University School of Medicine in St. Louis, and colleagues conducted a randomized controlled trial involving women with a body mass index (BMI) of 30 kg/m² or more undergoing surgery by a gynecologic oncologist through midline vertical incision. Participants were randomly allocated to skin closure with staples or subcuticular 4-0 monofilament suture.
A total of 163 women were analyzed between 2013 and 2016, including 84 who received staples and 79 who received suture. The researchers observed no between-group differences in wound complication rates (33 percent for staple and 32 percent for suture skin closure; relative risk, 1.05; 95 percent confidence interval, 0.68 to 1.04). Compared to women with suture closure, women with staples reported worse median cosmetic scores (four of five versus five of five), darker scar color (49 versus 18 percent), and more skin marks (40 versus 4 percent). Significant correlates of wound complication included BMI, maximum postoperative glucose, and cigarette smoking.
"Closure of midline vertical skin incisions with subcuticular suture does not reduce surgical site wound complications compared with staples in obese gynecology patients," the authors write.
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